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Wednesday, January 01, 2014

Before "Proof of Heaven" Made Dr. Eben Alexander Rich and Famous, He Was Something Else Entirely . . . . An Expose

Eban Alexander's Proof of Heaven: A Neurosurgeon's Journey into the Afterlife generated a lot of dismay and consternation in the neuroscience and consciousness worlds. General readers, however, suffered little exposure to all the commentaries on how little Alexander understands of how the brain functions, and they made Alexander wealthy and the book a best-seller.

But now Esquire has done a bit of research into the veracity of the story Alexander weaves in Proof of Heaven - the facts are largely contradictory. For example:Book: His coma was induced by an e. coli infection causing bacterial meningitis.Reality: His coma was induced by the doctors to, essentially, put him on pause while they figured out how to reduce his agitation and screaming.

Book: He claims of his days in the coma, "if you don't have a working brain, you can't be conscious." This is important, "he claims that his memories could not have been
hallucinations, since he didn't possess a brain capable of creating even
a hallucinatory conscious experience."Reality: Dr. Laura Potter, who was on duty the morning he was brought in and who oversaw the efforts to reduce his sedation and bring him out of the coma, does not believe he was in any way brain dead.

I ask Potter whether the manic, agitated state that Alexander
exhibited whenever they weaned him off his anesthetics during his first
days of coma would meet her definition of conscious.

"Yes," she says. "Conscious but delirious."

These are two of the more crucial facts that were lost in the use of "artistic license." He told Dr. Potter that aspects of his book were "dramatized, so it
may not be exactly how it went, but it's supposed to be interesting for
readers."

Anyway. I knew this was a questionable book at best, but now it's clear that this may have been a calculated reinvention for a man no longer practicing medicine.

The ProphetBefore Proof of Heaven made Dr. Eben Alexander rich and famous as a "man of science" who'd experienced the afterlife, he was something else: a neurosurgeon with a troubled history and a man in need of reinvention BY LUKE DITTRICHPHOTOS BY BRIAN FINKE

On December 18, 2012, the set of Fox & Friends was both festive and somber. Festive because it was the Christmas season. The three hosts, two men in dark suits flanking a woman in a blue dress, sat on a mustard-colored couch in front of a cheery seasonal backdrop: a lit-up tree, silver-painted twigs, mounds of tinsel, blue and red swatches of fabric, and, here and there, multicolored towers of blown glass with tapering points that made them look surprisingly like minarets. Somber because a terrible thing had happened just four days earlier, in an elementary school in Newtown, Connecticut. All three hosts looked sad, but the woman, Gretchen Carlson, looked the saddest.

When Alexander got sick in late 2008, he hadn't practiced surgery in a year and faced a $3 million malpractice lawsuit. He now has a best-selling book and a movie deal.

The shot of the three hosts occupied most of the right three quarters of the screen. A guest was joining them by satellite from another location, and a shot of his head and shoulders occupied most of the rest of the screen. This was his third appearance on the program in the last few months. He wore a dark blazer and a button-down shirt with blue stripes. He was middle-aged and handsome in an old-fashioned way, with tanned skin and thick hair parted on the right. The banner below the video feeds read, HOPE IS NOT LOST: NEUROSURGEON SAYS HEAVEN IS REAL. "Dr. Alexander," Carlson said, "if people don't know your story, you, you were ill, you were in a coma, you left this earth for a week, you were in heaven, and then you wrote about your experiences there, and you were told that you were supposed to come back to the earth." She paused. She looked into the camera and then looked up toward the studio ceiling and rocked slightly forward. "As people are grappling with the horrible nature of this tragedy," she said, her voice cracking, her lower lip trembling, "will these children forget, when they are in heaven, what happened to them?" It was, let's be clear, an unusual question. One imagines the host of a national news program would feel comfortable posing this question to only a very few guests. A priest? A bishop? The pope? But let's be clear about something else: Dr. Eben Alexander was presented as more qualified to answer this question than all of them. His authority on heaven hadn't come from prayer or contemplation or a vote taken at some conclave. He had been there. And although a lot of people might make similar claims concerning visits to heaven and the receipt of personal revelations from God and be roundly dismissed, Dr. Alexander was different. He was, as the Fox News Web site declared, a "renowned neurosurgeon." A man of science at the summit of the secular world. And when he answered the unusual question, he did so without hesitation, without hedging, and with the same fluency and authority he might exhibit when comforting a patient about an upcoming operation. "Well, they will know what happened," Alexander said, and a hint of sadness swirled in his own eyes for a moment. "But they will not feel the pain." His voice was southern and smooth, soft and warm. The shots of the studio and of the satellite feed faded away, and a heartbreaking tableau faded in, a grid of photographs. Fourteen children, each just six or seven years old, each smiling, each now, the viewer knew, dead. Alexander's voice, soothing, heartfelt, poured on. "They will feel the love and cherishing of their being back there. And they will know that they have changed this world." Now the views of the studio and of Dr. Alexander faded back in, and the host to the left of Carlson, Brian Kilmeade, a compact and gruff guy with a sheaf of papers stacked on the table in front of him like a prosecuting attorney, asked a question. It was another unusual question and perhaps that's why Kilmeade prefaced it with a reiteration of what made their guest uniquely qualified to answer it. "So Dr. Alexander," he said, "your book, your book—and you're a neurosurgeon, you never believed in this until it happened to you, and you were brain-dead for a week, and your friends who work in your business say that there's no way you could have possibly come back, there was no activity there. Where is the shooter?" Alexander nodded along as the man posed the question and again answered without pausing. "The shooter is in a place of reviewing his own life," he said while the camera showed Gretchen Carlson wiping the tears from her eyes. "It's a very real phenomenon, of reliving all of the events of one's life and reliving the pain and suffering that we've handed out to others. But from their point of view." This is a story about points of view. He meets me at the door of his home and invites me in. He and his wife purchased the house in 2006, and it sits on a half acre of land in Lynchburg, Virginia, near a hospital where he used to work. Its exterior is red brick, and there are eleven windows along the front, each with white trim and black shutters, making the house look sort of Jeffersonian, sort of Monticelloesque, though it's actually only forty-nine years old, which makes it ten years younger than Alexander himself. He's wearing jeans and a button-down shirt and a sweater vest, and he leads me through a wood-paneled study to the kitchen, where he asks if I'd like a cup of coffee. While the coffee brews, he explains how caffeine works. "It kind of affects the second transmitter system, part of the fight-or-flight mode.

UNC yearbook, 1976.

And it gets you more into kind of an active state. It bypasses some of the primary transmitters there, kind of activates the whole system, so it revs you up. It works very effectively. So, you do not take sugar?" Once the coffee's ready, we return to the study. The room is homey and filled with family pictures and some paintings by friends of his wife, Holley, who's an artist and art teacher. Alexander met her in college when she was dating his roommate, and now they have two sons. She comes into the study and sets a plate of cookies and apple slices down on a coffee table for us to pick at. "I'm starting to get a little more practice with these interviews," Alexander says. "It might not show, but I should be learning from it all. It's been quite a journey." We talk for hours. We talk about his past life and his present one, and about the strange voyage that divided the two. We talk about some of the stories he tells in Proof of Heaven, which has sold nearly two million copies and remains near the top of the New York Times best-seller list nearly a year after its release. We also talk about some of the stories you won't find in the book, stories I've heard from current and former friends and colleagues, and stories I've pulled from court documents and medical-board complaints, stories that in some cases give an entirely new context to the stories in the book, and in other cases simply contradict them. From one point of view, the point of view that Fox & Friends and Newsweek and Oprah and Dr. Oz and Larry King and all of his other gentle interrogators have helped perpetuate, Dr. Eben Alexander is a living miracle, literally heaven sent, a man capable of finally bridging the chasm between the world of spirituality and the world of science. From this point of view, he is, let's not mince words, a prophet, because after all, what else do you call a man who comes bearing fresh revelations from God? This point of view has been massively profitable for Dr. Eben Alexander, has spawned not just a book sold in thirty-five countries around the globe but a whole cascade of ancillary products, including a forthcoming major motion picture from Universal. But there is another point of view. And from this point of view, Dr. Eben Alexander looks less like a messenger from heaven and more like a true son of America, a country where men have always found ways to escape the rubble of their old lives through audacious acts of reinvention. By the end of our interview, there's a note of unease in Alexander's voice. He pulls out his iPhone and puts on the voice recorder. He tells me he is concerned that some of the stories I've brought up could be taken the wrong way by readers. "People could definitely go way off the deep end about irrelevant stuff as opposed to focusing on what matters," he says. Before he was Eben, he was, briefly, Richard. His biological parents, young, unready, created him, named him, and then gave him away. The Alexander family of Winston-Salem, North Carolina, adopted him and gifted him with a new name, one with an illustrious pedigree. The first Eben Alexander, his great-grandfather, was the U. S. ambassador to Greece in the 1890s, helped create the modern Olympic Games, carried on an occasional correspondence with Mark Twain. His father, Eben Alexander Jr., a great neurosurgeon, was permanent president of his class at Harvard Medical School. Eben Alexander III attended Phillips Exeter Academy, where he read lots of science fiction, grew a shaggy mop of hair, learned how to pole-vault—he loved the feeling of propelling himself skyward with physics and muscle. While his high school classmates saved up for cars, he bought himself sailplane lessons. He went to college at the University of North Carolina at Chapel Hill. He studied chemistry. He contemplated astrophysics. He joined the Sport Parachute Club and spent his weekends flying to great heights in perfectly good Cessna 185's and jumping out of them. He felt drawn to medicine but worried that if he became a doctor, he'd never escape his father's shadow. He agonized. He graduated from UNC in 1975 and enrolled in Duke medical school. He was still worried about not living up to the standards set by his father. Even after he began his neurosurgery residency, he almost jumped ship, changed careers. He sent in a job application to NASA. He dreamt of flying on the space shuttle, of helping to build the International Space Station. But when he told his father, his father convinced him to withdraw the application. Wait till you've finished your residency, he told him. Then, if you're still interested in the whole NASA thing, by all means. By the time he'd finished his residency, the Challenger had exploded and the shuttle program was on hold. He chose not to reapply. His path seemed set. A headache. November 10, 2008. He has a headache. Not a bad one at first, but it gets steadily, rapidly worse. He tells Holley that he just needs to rest, that he'll be fine. Escherichia coli bacteria have insinuated themselves into the lining of his central nervous system, the membranes that protect his brain and spinal cord, he writes in Proof of Heaven. It is unclear how they got there. Spontaneous cases of bacterial meningitis are rare but not unheard of, and the transmission vectors are the same as those of other common infectious diseases: tainted water supplies, poor hygiene, dirty cooking conditions. Regardless of where these particular E. coli came from, now that they're here, they proliferate. E. coli populations are incredibly fertile, and under ideal circumstances will grow exponentially, doubling in size every twenty minutes. Theoretically, given limitless food and zero resistance, a single 0.000000000000665-gram E. coli bacterium could in nineteen hours spawn a megacolony weighing as much as a man. But our bodies are not defenseless. Alexander's immune response kicks in immediately, deploying fleets of white blood cells to kill the invaders. His cerebrospinal fluid, the fluid that supports his brain in every sense, buoying it and nourishing it, becomes a terrifying battlefield. While the invaders consume his CSF's brain-sustaining sugars, the defensive onslaught of white blood cells causes the volume of fluid to swell, raising the pressure inside his skull. By the time the EMTs wheel him into the ER at Lynchburg General Hospital, his besieged brain, choked and starving, is severely dysfunctional. He is raving, thrashing, incoherent. Then he slips into a coma. His path seemed set.He finished his neurosurgical residency and, in 1988, was hired at one of the most prestigious hospitals in the country, Brigham and Women's, in Boston. While practicing there, he taught at his father's alma mater, Harvard Medical School. The prestige of these institutions gave him access to some of the most remarkable new medical technology in the world. He became an expert at something called stereotactic radiosurgery, a type of treatment that burned away the problems inside a patient's brain, cauterizing aneurysms, cooking tumors, without the skull even needing to be opened. He was on the rise. His father's shadow no longer seemed so long. And he was charming. Larger than life, that's how his residents viewed him. A charismatic barrel of energy, with an endearing habit of always wearing a bow tie. He would play rock music in the operating room: classics like Jimi Hendrix, Led Zeppelin, and the Doors, newer stuff like Massive Attack, Five for Fighting, Goo Goo Dolls. And no, he'd never quite gotten over his obsession with space, with flight. Sometimes, when he wasn't around, the residents would even crack that he would have made a better astronaut than a brain surgeon. They'd noticed that some of the attending surgeons could completely lose themselves in an operation, standing there for hours, peering into a tiny little hole and meticulously extracting bits of tumor. But Dr. Alexander wasn't like that. He'd come rushing into the OR, talking to the nurses and the residents and anyone else who'd listen, rambling about near-earth asteroids or dark matter or whatever other topic in astrophysics he'd been reading about in his spare time. It would take him a while to get down to business, to focus on the matter at hand. It wasn't that he wasn't smart. Four different former residents of Alexander's use the word brilliant to describe him. But he often just seemed to be somewhere else. He is somewhere else. Where, he doesn't know. He doesn't know, really, anything. Not where he is, not even who or what he is. He is pure awareness, pure present, no past, no future. Just this little speck of consciousness adrift in a vast and mysterious place. It is an unpleasant place, brown and rank and suffocating, but he doesn't even know enough to define a term as advanced as "unpleasant." And then he sees the light. A bright light, swirling above him, accompanied by the most beautiful music. He is rising up toward it. Up through it. The unpleasant place is gone, somewhere below him, and now he is in a place that even if he had the power of vocabulary, of words, he would find almost indescribably beautiful. It is a green and verdant place. A green, idyllic place filled but not crowded with men and women in peasant garb. Here and there a dog cavorts among them. And he, he is flying! He is on the wing of a butterfly. Perhaps it is an enormous butterfly or perhaps he is really tiny, but size and scale don't really mean anything. There are other butterflies all around him, millions of them, perhaps an infinite number of them, colorful and iridescent, all flying in loose formation over this impossibly beautiful place. And he is not alone. Beside him on the butterfly, a beautiful girl! Like the green countryside, her beauty is so intense, so overpowering, that the word beauty itself seems insufficient. He becomes aware that she is speaking to him, saying something, though she doesn't even need to move her lips to speak. You are loved and cherished, she tells him. You have nothing to fear.

There is nothing you can do wrong. He didn't do anything wrong. He destroyed the woman's acoustic neuroma, a benign brain tumor, burned it to oblivion with focused beams of radiation. That's what he set out to do, and that's what he did. And yes, there had been postoperative inflammation, and yes, the surgery had left the woman with permanent paralysis on the left side of her face, but remember we're talking about brain surgery here, not splinter removal. Bad things can happen that are completely out of your control. The woman's lawsuit, however, didn't accuse him of doing something he shouldn't have done. It accused him instead of not doing something he should have done. Specifically, it accused him of not informing the woman that permanent facial paralysis might result from the operation. And so, because exactly what he had told her prior to the operation was at the heart of the case, that's what the lawyers asked her about during the deposition a few years later. She was an elderly woman from Arizona. She had initially consulted with Dr. Alexander by telephone after seeing an episode of a PBS television program called Scientific American Frontiers that was narrated by Alan Alda and had highlighted Dr. Alexander and his remarkable stereotactic radiosurgery operations.

While in heaven, Alexander rode a butterfly with a beautiful girl. He realized later that she was the biological sister he'd never met.

She sent him her medical records, scheduled a time for the operation, and then flew with her husband and her son to Boston.

Patient: I was in a wheelchair, and we went down to this room and waited. At 8:30, approximately four or five men came into the room, and they didn't say not one word to me. They just came over and started sticking me with a needle for anesthesia. And then they started screwing this thing in my head. And I was bleeding and I was scared and I was shaking. I went into shock, and nobody said one word....

Lawyer: What happened next?

A: Then they put that bell on my—they tried to, and it was—they had to get a different one, because the one they had went clear down on my shoulder. I have a very short neck and they—maybe they had it with them. I don't know. I don't remember that. All I remember is the excruciating pain when they started screwing that into my head. I had four screws, two in the back and two in the front.

Q: Okay.

A: And I suppose it was an aide came in, and she knew that I was in shock, evidently, because she got a blanket and wrapped it around me, and she kind of held me. I was still in the wheelchair....

Q: During that whole time, none of these four or five men said anything to you, is that right?

A: Yes. When they started putting the novocaine or whatever it was in my head, I said, "Is one of you Dr. Alexander?" and this voice in back of me said, "Yes, I am." And I said, "Please come around so I can see you. I would like to see what you look like." And so he did. And we might have shaken hands. I don't remember that. And then he went back to doing whatever they were doing, screwing this thing into my head.

But none of this, again, is an indication of wrongdoing. A cold or distracted bedside manner is not criminal. The question was whether he had ever warned her about the possible complications. When the woman's lawyer asked to see the two-page informed-consent form that laid out the risks, Alexander could find only the first page, the page without the woman's signature. And that page, as the lawyer noted, had "multiple punch holes and fray marks, indicating that it had been filed in [the patient's] chart, extracted from the file, and later refiled." Further, he said, additional documents also had gone missing, including a letter that the patient's primary neurosurgeon had sent to Alexander, notifying him of her postoperative facial paralysis. The woman's attorney argued that "it is reasonable to infer that this pattern of disappearance of probative evidence was not coincidental, but was in fact deliberate." The attorney was arguing, in other words, that when Alexander found things that didn't fit the story he wanted to tell, he changed them, or made them disappear altogether. Alexander settled. He soars on the butterfly's wing for who knows how long. Time is different. Space, time, self, everything: different. Above the butterflies, sentient orbs of light float. Angels? Who knows. But eventually he rises, even higher. Or deeper. Further. He enters a new realm, one of infinite depth and infinite blackness. And at the center of it all, a light. Bright, pulsating, warm, loving, wise. The embodiment, the definition, the source of all of those things and everything else. The all-knowing and all-loving creator at the center of all existence. He approaches God. God approaches him. God is everywhere. Above. Below. Beside. Inside. He and God are One. And although he still doesn't know who he is or where he is, though he still has no concept of language itself, of present, of past, none of that matters. He knows. He knows...everything. He knows the unknowable, the great mysteries, the answers to the ultimate whys and wheres and whats. Why are we here? Where did we come from? What do we do now? He knows it all. And then he falls away. Down through the valley of swirling butterflies. Back into the ageless muck where his journey began. So he settled that suit. But these things happen. You're trying to fix people who would otherwise be hopelessly broken, and sometimes you don't succeed, or things just go a little awry. And too often there are lawyers waiting in the wings. It didn't really affect him. He was still teaching at Harvard, still practicing at the Brigham. He was still on the rise. There were some tensions at work, though. He and the man he worked for, Dr. Peter Black, the Brigham's chair of neurosurgery, weren't getting along. Why that is depends on whom you ask. Alexander thinks it's because Black had assigned him to head up the hospital's stereotactic-radiosurgery program, and initially that technology was used only to treat aneurysms. The technology had developed quickly, though, and soon Alexander was using it on tumors, too. He'd also begun using the hospital's new intraoperative MRI machine to do tumor work. Problem was, Black was known worldwide as the tumor guy. For instance, when Ringo Starr's daughter was diagnosed with a brain tumor, her doctors sent her across the Atlantic, because only Black would do. Alexander thought Black was maybe worried that Alexander was encroaching on his turf, and this was straining their relationship. Black, for his part, has no comment. But all in all, more than a decade into his career at the Brigham, things were looking great. He coauthored a lot of journal articles and two academic textbooks, one about stereotactic radiosurgery and the other focusing on the intraoperative MRI machine. And then, in 2000, he served as the inspiration for a best-selling novel. His friend wrote it. The Patient, by Michael Palmer. A medical thriller, the kind travelers snatch up in airports and devour on airplanes. A French terrorist dying from a brain tumor takes a prestigious Boston hospital hostage in order to force the staff to save his life. Initially, the terrorist wants the operation performed by the chief of the neurosurgery department, Carl Gilbride, but Gilbride soon reveals himself to be a venal and incompetent blowhard whose "true forte was self-promotion." The real star of the neurosurgery department, the terrorist deduces, is a young firebrand named Jessie Copeland, who is everything a patient could hope for: brilliant, selfless, compassionate, fiercely devoted to her charges, and a wizard with a scalpel. When the terrorist chooses Copeland to perform his operation, it rankles Gilbride so much that he begins trying to thwart and sabotage her at every turn.

THE DALAI LAMA WAGS A FINGER AT ALEXANDER. WHEN A MAN MAKES EXTRAORDINARY CLAIMS, HE SAYS, A "THOROUGH INVESTIGATION" IS REQUIRED, TO ENSURE THAT PERSON IS "RELIABLE," HAS "NO REASON TO LIE."

Palmer had learned everything he could about neurosurgery from Alexander and channeled it into the book, into Copeland. Alexander had even passed along to Palmer the idea for ARTIE, the robotic assistant that could crawl straight up someone's nose and into their brain and, when combined with an intraoperative MRI machine, resect even the most stubbornly embedded tumors. When folks at the Brigham read The Patient, it took them about a half second to realize that Copeland was a stand-in for Eben Alexander (albeit under the diaphanous disguise of a sex change). And it didn't take much longer than that for them to realize that the vile, venal chief of neurosurgery, the fictional Carl Gilbride, was supposed to be the Brigham's real-life chair of neurosurgery, Eben Alexander's boss, Peter Black. As one former resident of Alexander's puts it, the "animosity and dynamic is eerily identical." Alexander, he says, "poured all his frustration in there through Palmer," though he cautions the resulting portraits of Alexander and Black are "open to interpretation and tinted with jealousy." In the fictional world of the book, Carl Gilbride gets what's coming to him. He is pistol-whipped and roundly humiliated, and by the end is so entirely emasculated and subservient to Copeland that he seeks praise from her "like a four-year-old announcing he had picked up all his toys." In the real world, things turned out differently. On April 13, 2001, almost exactly a year after the publication of The Patient, Dr. Eben Alexander's employment as a surgeon at the Brigham was terminated. Rumors flooded the hospital hallways and break areas—a problem with a patient? simply too much ego in one place?—but none were ever substantiated. The administrators, as is their bureaucratic wont, stayed silent. Only one fact was indisputable: Dr. Eben Alexander III was moving on. He falls and rises and falls and rises. Back in the muck and murk of the realm below the verdant place, below God, he eventually, after seconds or hours or days or years or millennia, discovers that he is in control. That he can ascend again. All he needs to do is summon the melody, the one that accompanied the initial portal, and then he'll float up and through it and be back on the butterfly again, with the beautiful girl, ready for another encounter with God. He repeats the pattern, falling down, rising up, countless times. But eventually the melody stops working. Eventually the melody no longer summons the glowing gateway. It doesn't bother him, really. Even there, in the writhing brown and grime, he knows that he is loved, eternally, that he can do nothing wrong, that nothing truly bad can ever happen to him. Secure in this knowledge, and in all his other newfound wisdom as well, he slowly becomes aware of another realm. Faces emerge from the murk and present themselves to him, and although he doesn't recognize them, although he doesn't know who they are, he senses their concern for him. Their love. They come from where he comes from. He begins to wake up. It's time to go back. It was time to go back, to head back home to the South. New England hadn't quite worked out. After the Brigham, he'd taken a job at the UMass Memorial Medical Center, in Worcester, thirty-five miles west of Boston. He'd run its deep-brain-stimulation program, implanting electrodes into patients, helping alleviate their Parkinsonian tremors by means of corrective shocks. But there had been more lawsuits—in one case, a bit of plastic was left behind in a woman's neck—and there had been another boss he didn't get along with. In August 2003, UMass Memorial suspended Alexander's surgical privileges "on the basis or allegation of improper performance of surgery." (The specifics of the case leading to the suspension are confidential, though Alexander claims it resulted from "a very complex repeat operation I did around the brain stem of a patient in which the patient had more difficulty recovering after the operation I would say than I anticipated and than I led them to believe.") His suspension technically ended in November of that same year, but he never went back to work at UMass Memorial. He resigned. The following year he did a little freelance consulting for the Gerson Lehrman Group, a company that matches corporations with experts in various fields, and also filed an unsuccessful lawsuit against the Brigham and Women's Hospital, claiming it improperly withheld more than $400,000 of his retirement and deferred-compensation plans. He had been more or less out of work for fifteen months when, in March 2005, he received a letter from the Massachusetts Board of Registration in Medicine asking him to respond to a complaint form they'd received from a former patient who was upset that Alexander had stopped responding to phone calls. Alexander wrote a letter back, explaining that the complaint was invalid because he was no longer practicing and that, furthermore, he would soon be leaving the state altogether.

"I wanted to stay in Massachusetts, but [the UMass chair of surgery's] campaign against me has made that impossible," he wrote. He added that he was a very good neurosurgeon, and that "Massachusetts would be most fortunate to have the benefit of my skills as a physician and surgeon over the next fifteen years, but they won't have it, because I am leaving this state for a more hospitable and welcoming environment. It will be nice to be appreciated for all that I have to offer."

The board ultimately took no disciplinary action. Still, one year later, he moved his family back south, into a big redbrick colonial house in Lynchburg, Virginia, not far from where he grew up, and Lynchburg General Hospital hired him as a staff neurosurgeon. He got back to work. When he comes back, when he opens his eyes, when the new-old realm with all its fresh-familiar sensations comes washing over him, he is at first very confused. For the better part of the next week, he experiences what is known as ICU psychosis. He hallucinates. Some of the hallucinations are very strange. At one point he believes he is running through a cancer clinic in south Florida, being pursued by his wife, a pair of policemen, and two Asian ninja photographers. His vocabulary is incomplete. Parts of his brain are still dysfunctional. But slowly his brain comes back online. Reality imposes itself. He becomes aware of who the people around him are. His family, his friends. He becomes aware of exactly where he is. He remembers this place. The sorts of operations Alexander performed at Lynchburg General Hospital were old-fashioned, as far as neurosurgery goes. But that doesn't mean they were unimportant. For example, on March 1, 2007, a fifty-four-year-old tobacco farmer from a small town outside of Lynchburg visited Dr. Alexander, complaining of pain in his neck and trapezius and upper arm. Alexander conducted a physical examination and inspected some MRI imagery and told the patient that he recommended a spinal decompression surgery that would involve fusing his fifth and sixth vertebrae. The patient agreed to the surgery, and several months later, on June 27, 2007, Alexander performed it. He did something wrong. Instead of fusing the farmer's fifth and sixth vertebrae, he fused his fourth and fifth. He did not realize his mistake at first. When he dictated the operative report, he recorded that the "MRI scan showed significant disk bulge and disk osteophyte complex compression at C5-6 mainly the left side," and then described an operation on those vertebrae, instead of the vertebrae he had actually operated on. On July 12, he had his first follow-up appointment with the farmer. He reviewed the postoperative X-rays. He noticed his mistake. He didn't tell his patient. Instead, after his patient went home, he pulled the operative report up on his computer and edited it. Now the report read that the MRI scan had showed disk bulge at both C4-5 and C5-6, and that "we had discussed possible C5-6 as well as C4-5 decompression, finally deciding on C4-5 decompression." Then he simply found every subsequent reference in the report to C5-6 and changed it to C4-5. After he finished editing the report, it read as though he hadn't done anything wrong at all. During a third follow-up meeting, in October, Alexander finally confessed, and told the patient that if he wanted another operation he could have it for free. It is unclear exactly when Lynchburg General Hospital learned of Alexander's mistake, but by the end of October he no longer had surgical privileges at the hospital. On August 6, 2008, the patient filed a $3 million lawsuit against Alexander, accusing him of negligence, battery, spoliation, and fraud. The purported cover-up, the changes Alexander had made to the surgical report, was a major aspect of the suit. Once again, a lawyer was accusing Alexander of altering the historical record when the historical record didn't fit the story he wanted to tell. By the time the lawsuit was filed, Alexander had found another job, with a nonprofit called the Focused Ultrasound Foundation in Charlottesville, Virginia, an hour-and-a-half drive from Lynchburg. His new job did not involve the practice of neurosurgery. His boss, the neurosurgeon Dr. Neal Kassell, who was also a professor of neurosurgery at the University of Virginia medical school, had known Alexander for many years. He had high respect for Alexander's intelligence—like Alexander's former residents, he described Alexander as brilliant. He had less esteem for Alexander's surgical abilities. "Neurosurgery requires the ability to intensely concentrate on one thing for a long period of time," he says. "And that's not Eben's MO." The tobacco farmer's lawsuit was still in its preliminary stages, hanging over Alexander's head like a $3 million hammer, when the E. coli started their terrible multiplication. He goes home from the hospital just before Thanksgiving. He is sixteen pounds lighter and still foggy, but getting stronger and sharper every day. He had been scheduled to give a deposition in the case of the tobacco farmer in December, but the court allows it to be pushed back. He keeps himself busy. He writes thank-you postcards to some of the medical staff that took care of him. He takes notes about his memories of his strange comatose journey, the murky place and the butterflies and the countryside and the dazzling epiphanic light at the center of it all. He imagines there is probably a neurological explanation for what he experienced. Eventually he starts going back to work at the Focused Ultrasound Foundation. On March 18, 2009, Alexander gives his deposition in the tobacco-farmer case. He testifies that when he learned of his error, he "felt like [he'd] been hit by a truck," but that he refrained from telling the patient because he was intrigued by postoperative improvements he claims the patient had made despite the botched operation. "I thought that I would end up telling him about it," he says, "and I think my overwhelming curiosity about why he had gotten better—I wanted to see if his symptoms came back quickly because people sometimes will have a placebo effect to surgery." Soon after his deposition, Alexander's lawyers urge him to settle, and he does. They also urge him to settle another case, stemming from an operation he performed only two weeks after the farmer's, when he again operated on the wrong vertebra of a patient. He settles that case, too. The Virginia Board of Medicine allows him to keep his license, but levies a modest fine and orders him to take continuing education classes in ethics and professionalism. By the time all his pending cases are resolved, Alexander will have settled five malpractice cases in the last ten years. Only one other Virginia-licensed neurosurgeon has settled as many cases in that time period, and none have settled more. But really, in the wake of his coma, his perspective on his legal troubles has shifted. He's just lucky to be alive. The mere fact of it, the mere fact that his brain survived that vicious bacterial assault, well...some might even call it a miracle. He starts reading a lot about near-death experiences, books like Life After Death, by Dinesh D'Souza; Embraced by the Light, by Betty J. Eadie; and Evidence of the Afterlife, by Jeffrey Long. These books all argue that experiences such as the one he had were not hallucinatory quirks of a brain under siege. They were real. One morning, maybe four months after his coma, he's in his bedroom reading one of these books, called On Life After Death, by Elisabeth Kübler-Ross. He comes to a story about a little girl who has a near-death experience during which she meets a deceased brother she had never known. Alexander, who had recently received a photo of a deceased daughter of his birth parents, a sister he had never known, puts the book down and lets his eyes wander to the photo. And then, suddenly, he recognizes her. The girl on the butterfly wing. He can't sleep. For days and weeks and months in a row, he wakes at two in the morning and can't fall back asleep, so he goes to the den long before he needs to start his long commute to work, and he writes and reads and thinks. He knows he has a story to tell, but the question is how to tell it. He eventually decides to start with the story of his first near-death experience. It's a story from his skydiving days back in college. He logged more than three hundred jumps during his college career, and most of them were thrilling but otherwise uneventful. On one autumn day in 1975, however, something went wrong. On that particular day, he was the last of a group of six jumpers to exit the airplane. The group had intended to form a six-man star formation, but one flew in too fast and knocked the formation apart before Alexander could come in to complete it. After recovering their bearings, the briefly discombobulated jumpers tracked away from one another, preparing to deploy their chutes. Alexander did the same, rocketing off to stake out his own untrammeled patch of sky. He was about to pull his rip cord when he noticed with a start that a jumper named Chuck had tracked to a spot directly below him. He describes the moment:

He must not see me. The thought barely had time to go through my head before Chuck's colorful pilot chute blossomed out of his backpack. His pilot chute caught the 120-mph breeze coming around him and shot straight toward me, pulling his main parachute in its sleeve right behind it. From the instant I saw Chuck's pilot chute emerge, I had a fraction of a second to react. For it would take less than a second to tumble through his deploying main parachute, and—quite likely—right into Chuck himself. At that speed, if I hit his arm or his leg I would take it right off, dealing myself a fatal blow in the process. If I hit him directly, both our bodies would essentially explode.

Instead, Alexander managed to react in the most perfect way possible to the scenario, instantaneously and without conscious effort angling his body so that it rocketed away from Chuck, avoiding disaster by microseconds. At the time, he marveled at what he believed must have been his brain's untapped capacity for preternaturally quick thinking. Now he interprets this incident differently.

This book is about the events that changed my mind on the matter. They convinced me that, as marvelous a mechanism as the brain is, it was not my brain that saved my life that day at all. What sprang into action the second Chuck's chute started to open was another, much deeper part of me. A part that could move so fast because it was not stuck in time at all, the way the brain and body are.

He has his beginning. There was a man named Chuck in the University of North Carolina at Chapel Hill Sport Parachute Club. He won't return phone calls. But his sister-in-law does. She's read Proof of Heaven. She immediately thought to herself that the Chuck in the book must have been her brother-in-law. She sends Chuck a few e-mails. Finally he responds. He remembers Alexander. He says he doesn't remember anything like the incident Alexander describes. Alexander can understand the confusion. "It's not Chuck," he says today. "I probably should have put a disclaimer in the front of the book saying that Chuck is not Chuck. It is actually somebody not named Chuck. Because I cannot give the name of the person it was. Because the attorneys at Simon & Schuster would be mad at me. Because potentially they did something wrong. Potentially they were liable for causing trouble, etc., etc. So I am under very strict advice from the Simon & Schuster attorneys not to divulge who that was." But if the man who'd opened the chute below him had done something wrong, it was something wrong that hadn't caused any personal injury. There wouldn't have been any legal liability there, right? "Right," he says. "Well, that was my argument, but these attorneys, it was kind of surprising to me, that was one of the few things they focused on. They said, 'Do not, under any circumstances, divulge who that was!' " So he had changed the character's name to Chuck, which happened to be the real name of someone he did skydive with? "It's not Chuck," he repeats. "It's not Chuck." Is he still in touch with Chuck? "No." And fake Chuck? "No, I don't know what happened to fake Chuck." Is there anyone else who was part of the jump that day who might be able to verify his story? "You know, there's not. Because I can't tell you exactly which day it was. And my logbook—those pages in my logbook I don't have right now." The book progresses. He starts to hone his argument and to shape its presentation. He is, he writes, "a practicing neurosurgeon" and is familiar with "the most advanced concepts in brain science and consciousness studies." His "decades of research and hands-on work in the operating room" put him "in a better-than-average position to judge not only the reality but also the implications of what happened to me." He introduces his central thesis. "During my coma," he writes, "my brain wasn't working improperly—it wasn't working at all." This is the key. His brain wasn't working, and yet he had these vivid memories of voyaging through these other realms: the murky dark, the butterflies, the vast darkness, and the luminous, all-knowing creator. How could he have memories from a time when his brain wasn't working at all? From a time when, as he writes, "my mind, my spirit—whatever you may choose to call the central, human part of me—was gone." The answer is simple and logical. It is also, he writes, "of stunning importance. Not just to me, but to all of us." Alexander writes, "The place I went was real, real in a way that makes the life we're living here and now completely dreamlike by comparison." As he nears the end of his tale, every part of his story seems to be connected to every other part in mysterious ways. For instance, his coma began on Monday, November 10, and by Saturday, "it had been raining for five days straight, ever since the afternoon of my entrance into the ICU." Then, on Sunday, after six days of torrents, just before he woke up, the rain stopped:

To the east, the sun was shooting its rays through a chink in the cloud cover, lighting up the lovely ancient mountains to the west and the layer of cloud above as well, giving the gray clouds a golden tinge. Then, looking toward the distant peaks, opposite to where the mid-November sun was starting its ascent, there it was. A perfect rainbow.

It was as though heaven itself was cheering Alexander's return. Dave Wert, meteorologist in charge at the National Oceanic and Atmospheric Administration office that encompasses Lynchburg, reviews the weather records for the week of November 10 through 16. "There was nothing on the tenth," he says. "Nothing on the eleventh...two hundredths of an inch on the twelfth." The next three days, he says, were rainy and miserable. Then the storm appeared to break on the evening of the fifteenth. The sixteenth was another clear day. Could there have been a rainbow on the morning of the sixteenth? "No," he says. Unlike weather records, Alexander's medical records are all confidential. Alexander does not plan to make them public, though he did offer to allow three of the doctors who treated him to speak about his case. Two of them declined the opportunity. The other, Dr. Laura Potter, was on duty in the ER of Lynchburg General Hospital on the morning of November 10, 2008, when the EMTs brought him in. Both Alexander in his book and Potter in her recollections describe Alexander arriving in the ER groaning and flailing and raving and having to be physically restrained. In Proof of Heaven, Alexander describes Dr. Potter then administering him "sedatives" to calm him down. Here's how Dr. Potter remembers it:

"We couldn't work with Eben at all, we couldn't get vital signs, he just was not able to comply. So I had to make the decision to just place him in a chemically induced coma. Really for his own safety, until we could treat him. And so I did.... I put him to sleep, if you will, and put him on life support."

After Alexander was taken from the ER to the ICU, Potter says, the doctors there administered anesthetics that kept him in the coma. The next day, she went to visit him. "And of course he was still in an induced coma," she says. "On ventilator support. They tried to let him wake up and see what he would do, but he was in exactly the same agitated state. Even if they tried to ease up, a little bit even, on the sedation. In fact, for days, every time they would try to wean his sedation—just thrashing, trying to scream, and grabbing at his tube." In Proof of Heaven, Alexander writes that he spent seven days in "a coma caused by a rare case of E. coli bacterial meningitis." There is no indication in the book that it was Laura Potter, and not bacterial meningitis, that induced his coma, or that the physicians in the ICU maintained his coma in the days that followed through the use of anesthetics. Alexander also writes that during his week in the ICU he was present "in body alone," that the bacterial assault had left him with an "all-but-destroyed brain." He notes that by conventional scientific understanding, "if you don't have a working brain, you can't be conscious," and a key point of his argument for the reality of the realms he claims to have visited is that his memories could not have been hallucinations, since he didn't possess a brain capable of creating even a hallucinatory conscious experience. I ask Potter whether the manic, agitated state that Alexander exhibited whenever they weaned him off his anesthetics during his first days of coma would meet her definition of conscious. "Yes," she says. "Conscious but delirious." Potter hasn't read Proof of Heaven, although she did get an advance look at a few passages. About a year after his recovery, Alexander approached Potter at a track meet that both of their sons were competing in and told her that he'd started writing a book, and that he wanted her to take a look at some parts in which he described her thought processes in the emergency room. He wanted, he said, to "make sure that you're okay with what I've done." He later e-mailed the passages to her, and when she read them, she found that they were "sort of what a doctor would think, but not exactly what was going through my head." She told him so, and according to Potter he responded that it was a matter of "artistic license," and that aspects of his book were "dramatized, so it may not be exactly how it went, but it's supposed to be interesting for readers." One of the book's most dramatic scenes takes place just before she sends him from the ER to the ICU:

In the final moments before leaving the emergency room, and after two straight hours of guttural animal wails and groaning, I became quiet. Then, out of nowhere, I shouted three words. They were crystal clear, and heard by all the doctors and nurses present, as well as by Holley, who stood a few paces away, just on the other side of the curtain. "God, help me!" Everyone rushed over to the stretcher. By the time they got to me, I was completely unresponsive.

Potter has no recollection of this incident, or of that shouted plea. What she does remember is that she had intubated Alexander more than an hour prior to his departure from the emergency room, snaking a plastic tube down his throat, through his vocal cords, and into his trachea. Could she imagine her intubated patient being able to speak at all, let alone in a crystal-clear way? "No," she says. He finds an agent, and the agent shops his book proposal around, and soon Simon & Schuster offers him a book deal. They put it on the fast track for publishing, want to get it out that same year. A writer named Ptolemy Tompkins, who has written other books about near-death experiences, is brought in to help chop down the manuscript by more than half. Alexander meets in New York with the publishers and his editor, but once the deal is struck, the gears of the publishing world grind on even when he's back down south. The title of the book, according to Alexander, is generated during a meeting he doesn't attend, a meeting between executives at Simon & Schuster and, according to him, executives at various ABC television programs, including Good Morning America, 20/20, and Nightline. During the meeting, the Simon & Schuster executives, who are trying to line up coverage for the book, are making their pitch—this renowned neurosurgeon visits the afterlife, comes back with wondrous stories to tell—and toward the end of the meeting an ABC executive asks if the Simon & Schuster execs can summarize what makes the book important. "It's proof of heaven!" someone blurts. In his study, toward the end of our conversation, Alexander distances himself from the title. "When they first came to me with that title I didn't like it at all," he says. "Because I knew from my journey that it was very clear to me that no human brain or mind, no kind of scientific philosophical entity will ever be able to know enough to say yes or no to the existence of that realm or deity, because it's so far beyond our human understanding." It is, he says, "laughable" and "the highest form of folly, of hubris" to think that anyone could ever "prove" heaven. "I knew," he says, "that proof in a scientific sense was ridiculous. I mean, no one could have that." We talk five weeks later by Skype. He's in a hotel in Vancouver, at the beginning of a one-and-a-half-week stint of speaking engagements and book signings. He looks relaxed, serene, wearing another button-down shirt, smiling into the Internet. He's excited to be on the road, he says, eager to spread his message of hope. He hasn't had surgical privileges since October 2007, but he still views himself as a healer. I remind him of what he said about his book's title during our previous meeting, and ask whether there were any parts of the book's contents he would concede are similarly hyperbolic. He says no, there are not. And he now says that not even the title is, strictly speaking, inaccurate. It just doesn't go far enough. "This is so much more than a proof of heaven," he says. "Proof of heaven is kind of a minuscule little claim compared to what is really there." We talk about rainstorms and intubations and chemically induced comas, and I can see it in his face, the moment he knows for sure that the story I've been working on is not the one he wanted me to tell. "What I'm worried about," he says, "is that you're going to be so busy trying to smash out these little tiny fires that you're going to miss the big point of the book." I ask whether an account of his professional struggles should have been included in a book that rests its authority on his professional credentials. He says no, because medical boards in various states investigated the malpractice allegations and concluded he could retain his license. And besides, that's all in the past. "The fact of the matter," he says of the suits, "is they don't matter at all to me.... You cannot imagine how minuscule they appear in comparison to what I saw, where I went, and the message that I bring back." His survival is a miracle, he says. His doctors told him that he is alive when he should be dead, and he believes intensely that he is alive for a reason, to spread the word about the love awaiting us all in heaven. To heal. By focusing on the inconsistencies in his story, on recollections that don't seem to add up, on a court-documented history of revising facts, on the distinctions between natural and medically induced comas, he says, is to miss the forest for the trees. That's all misleading stuff, irrelevant to his journey and story. Toward the end, there's a note of pleading in his voice. "I just think that you're doing a grave disservice to your readers to lead them down a pathway of thinking that any of that is, is relevant. And I just, I really ask, as a friend, don't..." The walls are light blue at the bottom and darker blue toward the top, like the May sky. There are flowers everywhere, purple and pink and white, sprouting from pots and floating in clear glass bowls. On a bright orange altar at the rear of the room, multiple swatches of cloth, yellow and red and green, hang from a life-sized golden statue of Buddha. The Dalai Lama reclines in a cushioned throne in front of the altar, under the Buddha. He's wearing a red robe with a yellow shoulder band that loops around and drapes over one of his arms, leaving the other arm, which is as smooth and hairless as a child's, exposed. Alexander is wearing a robe, too, but it's a standard black convocation robe. He's sitting a few feet to the left of the Dalai Lama, in a smaller chair. Both are here to speak at the graduation ceremony of Maitripa College, a Buddhist college in Portland, Oregon. Alexander is slated to speak first, and when he begins, the Dalai Lama cocks his head in a quizzical way and peers at him through his thick glasses. Alexander tells his story like he's told it so many times before, in his soft, southern, confident burr. He tells the audience about the wondrous realm he visited, about the all-powerful and all-loving God he encountered there, and about some of the lessons he's brought back to earth. He says that among those lessons is the fact that reincarnation is real, and that knowing death is only ever temporary has helped him understand how a loving God can permit so many "tragedies and hardships and hurdles in the physical realm." As he did a few months ago, when Gretchen Carlson asked him whether the dead schoolchildren from Newtown remembered their slaughter, he offers comfort and hope. "I came to see all of those hardships as gifts," he says, "as beautiful opportunities for growth." The Dalai Lama is not a native English speaker, and when it's his turn to speak, he does so much less smoothly than Alexander, sometimes stopping and snapping his fingers when a word escapes him, or turning to his interpreter for help when he's really stuck. He is not using notes, and the impression he gives is that of a man speaking off the cuff. He opens with a brief discourse about the parallels between the Buddhist and Shinto conceptions of the afterlife, and then, after glancing over at Alexander, changes the subject. He explains that Buddhists categorize phenomena in three ways. The first category are "evident phenomena," which can be observed and measured empirically and directly. The second category are "hidden phenomena," such as gravity, phenomena that can't be seen or touched but can be inferred to exist on the basis of the first category of phenomena. The third category, he says, are "extremely hidden phenomena," which cannot be measured at all, directly or indirectly. The only access we can ever have to that third category of phenomena is through our own first-person experience, or through the first-person testimony of others. "Now, for example," the Dalai Lama says, "his sort of experience." He points at Alexander. "For him, it's something reality. Real. But those people who never sort of experienced that, still, his mind is a little bit sort of..." He taps his fingers against the side of his head. "Different!" he says, and laughs a belly laugh, his robes shaking. The audience laughs with him. Alexander smiles a tight smile. "For that also, we must investigate," the Dalai Lama says. "Through investigation we must get sure that person is truly reliable." He wags a finger in Alexander's direction. When a man makes extraordinary claims, a "thorough investigation" is required, to ensure "that person reliable, never telling lie," and has "no reason to lie." Then he changes the subject, starts talking about a massive project to translate ancient Tibetan texts. Alexander listens quietly, occasionally fidgeting with the program in his hands. He's a long way from home, and even further from the man he once was. It's been a dizzying journey, but his path forward seems set. He's told people that God granted him so much knowledge, so much wisdom, so many secrets, that he will have to spend his entire life unpacking it all, doling it out bit by bit. He's already working on the follow-up to Proof of Heaven. In the meantime, anyone can pay sixty dollars to access his webinar guided-meditation series, "Discover Your Own Proof of Heaven," and he's been consulting with a pair of experts in "archaeoacoustics" to re-create some of the music that he heard while on his journey. You can even pay to join him on a "healing journey" through Greece. In his past life, Alexander went through some hard times, but those hard times are far behind him now. He is in a better place. ~ Luke Dittrich has been a contributing editor at Esquire since 2008. His work has appeared in numerous anthologies, including The Best American Crime Writing, The Best American Travel Writing, and The Best American Science and Nature Writing, and his article about a group of strangers who sheltered together during a devastating tornado won the 2012 National Magazine Award for Feature Writing. He is currently writing a book for Random House about his neurosurgeon grandfather's most famous patient, Henry Molaison, an amnesiac from whom medical science learned most of what it knows about how memory works.